Tony Shepherd's numbers on health don't add up

Jenna Price

Tony Shepherd is the man in charge of the National Commission of Audit and is using inaccurate numbers to push an ideological ordinary-Australian-hating line.

He’s making proposals based on numbers he can’t - or won’t - interpret accurately. He’s trying to encourage the government to introduce a sickness tax. That’s the same government who told us, before the election, that there would be no new taxes.

Here are some of the misinterpretations in the Commission of Audit.

Shepherd said Australians go to the doctor 11 times a year. Once a month (with a month off for holidays when we are clearly too happy to be sick). He uses the furphy that 82 per cent of our visits are bulk-billed.

Advertisement

Here are the facts gleaned from the Report on Government Services 2014. There were 5767.6 GP-type services per 1000 people in 2012-13 and that’s an average of just under six services per person.

Shepherd conflates item numbers with visits. That means that for those of you who have several item numbers all in one hit, that’s counted as individual visits.

For instance, I hate going to see the adorable Dr Pandora so much that I wait until I have a few things to see her about. It takes a while to do my vault smear and the various other goodies. She might also slice off the weird growthy thing on the back of my head.

Then I’ll get charged for a consultation as well as at least one other procedure. It’s those individual items that are being counted by Shepherd and not individual visits.

As well, the prospect of a co-payment is not in the future for many of us. Those services that are not bulk-billed attract, on average, a co-payment of nearly $30.

But if you don’t believe my analysis of the Report on Government Services, let me introduce you to Joan Henderson, senior research fellow and deputy director of the Centre for Bettering the Evaluation and Care of Health (BEACH). This is an independent research centre of a university, which surveys thousands of patient visits to GPs every year.

Here’s Dr Henderson’s measured but personal response when I asked her about the Shepherd figure of 11 visits per Australian.

''We scratched our heads when we saw it ... we regularly make this calculation for a lot of our analyses and we know that if you divide the claims to Medicare by the population, you get around 5.59 visits per person,'' she said. BEACH publishes those figures each year.

And what does this paragon of patience say about the concept of co-payments?

Not a good idea. Why?

''It disadvantages poorer people, it puts them off going to the doctor and in the long run, it is more costly because people are sicker when they go to the doctor.''

I asked Alison Verhoeven, chief executive officer of the Australian Healthcare and Hospitals Association, about the figures from the Commission of Audit.

She replied: ''I am unable to replicate Tony Shepherd's claim of 11 visits average per person to a GP.''

Verhoeven is also anxious about the prospect of co-payments: ''Timely access to healthcare services is important to people’s health and wellbeing ... deferring or not visiting a GP can result in poorer health.

''Nationally, in 2012-13, 5.8 per cent of respondents reported that they delayed or did not visit a GP in the previous 12 months because of cost.”

For indigenous people, that figure was more than 12 per cent.

Tim Senior, an adviser to the Royal Australian College of General Practitioners on indigenous health, thinks a co-payment will have a tremendous impact.

''Those who have the worst health have the least ability to pay,'' he says. No wonder Senior wants to start writing about the social determinants of health right now, while we are all still paying attention. Cutely, he’s called it Wonky Health.

What of the cost if we defer the visit to the doctor? I’m in the top 17 per cent of income earners these days but when my kids were little, I was right down the bottom. Would I have looked in my wallet to see if I had the co-payment before I took my daughter to the doctor in the middle of the night to discover she had meningitis?

As Richard Denniss, the director of the Australia Institute says: ''The Commission of Audit is silent on the likely increase in treatment costs from later detection.''

And silent on the emotional costs to parents of young children. Shepherd was too busy cutting costs to think about the social and emotional impacts of the proposals.

I cast around looking for someone with the kind of non-ideological purity I thought might cut through all this bullshit and happened upon a Nobel Laureate, Professor Peter Doherty, on Twitter.

''The Commission of Audit was a narrow bunch of people with a particular ideological viewpoint to play bad cop to the government’s good cop when it comes to bringing down the budget ... there is no secret about that.''

He describes the prospect of no Medicare access for high-income earners who already pay the Medicare levy as A Big New Tax.

And he says: ''Nobody expects politicians to be anything other than disgusting but these are particularly appalling. They may do immense damage to this country.''